Healthcare Compliance Resources

Single source for healthcare compliance best practices, regulatory updates, and industry news.

How Health Plans Can Meet 2026 Network Adequacy Requirements

Medicaid certification for network adequacy is entering a new era of regulation. Beginning in 2026, health plans face stricter federal standards, independent validation requirements, and continuous monitoring expectations that change how organizations demonstrate...

FACIS vs Other Healthcare Exclusion Databases

For healthcare compliance leaders, exclusion screening is not a routine administrative task; it is one of the most scrutinized elements of regulatory oversight. Civil monetary penalties, repayment exposure, audit findings, and reputational risk often trace back to one...

FACIS vs Other Healthcare Exclusion Databases

For healthcare compliance leaders, exclusion screening is not a routine administrative task; it is one of the most scrutinized elements of regulatory oversight. Civil monetary penalties, repayment exposure, audit findings, and reputational risk often trace back to one...

The Importance of Exclusion Screening in Healthcare

Healthcare organizations that employ or contract with excluded individuals face severe civil monetary penalties, repayment of all associated claims, and potential loss of Medicare and Medicaid participation. The stakes are clear: exclusion screening is not optional...

Market vs Verisys for Eligibility & Payment Integrity

Why Eligibility and Payment Integrity Matter More Than Ever Every improper payment tells a story,  not just about a claim, but about the controls behind it. For health plans, eligibility and payment integrity are no longer back-office functions. They are board-level...
The Importance of Exclusion Screening in Healthcare

The Importance of Exclusion Screening in Healthcare

Healthcare organizations that employ or contract with excluded individuals face severe civil monetary penalties, repayment of all associated claims, and potential loss of Medicare and Medicaid...

Market vs Verisys for Eligibility & Payment Integrity

Market vs Verisys for Eligibility & Payment Integrity

Why Eligibility and Payment Integrity Matter More Than Ever Every improper payment tells a story,  not just about a claim, but about the controls behind it. For health plans, eligibility and payment...

Physician Onboarding Checklist

Physician Onboarding Checklist

Hiring a new practitioner is a complex process for many healthcare entities. A physician onboarding checklist can help guide this process by clearly outlining the key steps required to onboard a new...

Webinars & Compliance Updates

February 2026 Legislative and Compliance Healthcare Updates

February 2026 Legislative and Compliance Healthcare Updates

This month’s compliance landscape features a major federal fraud enforcement action, a state-level government audit revealing critical data privacy failures, multi-state provider license revocations, and a reminder of the New Jersey Board of Pharmacy’s robust...

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January 2026 Legislative and Compliance Healthcare Updates

January 2026 Legislative and Compliance Healthcare Updates

    This month’s compliance landscape features enhanced federal cybersecurity guidance, notable False Claims Act enforcement actions, and significant financial risks associated with data breaches. These updates reinforce the need for proactive compliance...

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December 2025 Legislative and Compliance Healthcare Updates

December 2025 Legislative and Compliance Healthcare Updates

    Federal and state enforcement actions continued to close out 2025, reinforcing the importance of strong compliance oversight across healthcare operations. December’s updates highlight intensified mental health parity enforcement, renewed congressional...

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